Trulicity vs Zepbound is a diabetes shot vs a weight-loss shot. Trulicity (dulaglutide) is a weekly injection FDA-approved for type 2 diabetes. Zepbound (tirzepatide) is a weekly injection FDA-approved for weight loss and for obstructive sleep apnea in adults with obesity. Both come from Eli Lilly, but they aren't interchangeable, and Zepbound's label says using it with any other GLP-1 medicine, Trulicity included, isn't recommended.
So the real question is what you need treated: blood sugar, weight, or both. Below: what each one is approved for, what the trials showed, side effects, and what each costs in 2026.
The RX Index is the independent GLP-1 decision resource that scores telehealth providers and treatment paths on clinical legitimacy, care quality, transparency, access, and cost, so readers can choose the path that fits their situation.
Trulicity vs Zepbound at a glance
| Trulicity (dulaglutide) | Zepbound (tirzepatide) | |
|---|---|---|
| How often | Once a week | Once a week |
| How it works | GLP-1 only | GIP and GLP-1 (two hormones) |
| FDA-approved for weight loss | No | Yes, adults with obesity, or overweight plus a weight-related condition |
| FDA-approved for type 2 diabetes | Yes, adults and kids 10 and older | No (the same drug is sold for diabetes as Mounjaro) |
| Other FDA-approved use | Lowers the risk of major heart events in some adults with type 2 diabetes | Treats moderate to severe sleep apnea in adults with obesity |
| Label dose | Starts at 0.75 mg, up to 4.5 mg weekly | Starts at 2.5 mg, up to 15 mg weekly |
| Weight change in its own label trials | 3.0 to 4.6 kg (about 7 to 10 lb) at 36 weeks, adults with type 2 diabetes | 15.0% to 20.9% at 72 weeks, adults without diabetes |
| List price | $1,006.93 a month | $499 to $1,086.37 per fill |
| Lilly cash price | Starting at $389 a month | $299 to $699 a month, by dose |
| Maker | Eli Lilly | Eli Lilly |
Sources for every row are in the sections below.
Neither one is "better" for everyone. If you have type 2 diabetes, your plan and your A1C shape the choice. If weight is the main goal and you don't have diabetes, Trulicity isn't approved for that. If you want to see every option side by side, including other weekly shots and daily pills, The RX Index's Find My GLP-1 Path tool is free, takes about 2 minutes and needs no signup.
See which GLP-1 path fits your goal
What is each one FDA-approved for?
Trulicity is approved for type 2 diabetes. Zepbound is approved for weight loss and sleep apnea. That one difference drives coverage, price and which one your prescriber is likely to suggest.
| FDA-approved use | Trulicity | Zepbound |
|---|---|---|
| Blood sugar control, adults with type 2 diabetes | Yes | No |
| Blood sugar control, kids 10 and older with type 2 diabetes | Yes | No. Its label says safety and effectiveness in children haven't been established |
| Lower risk of major heart events, adults with type 2 diabetes and heart disease or several heart risk factors | Yes | No |
| Weight loss and keeping it off, adults with obesity, or overweight plus a weight-related condition | No | Yes |
| Moderate to severe obstructive sleep apnea, adults with obesity | No | Yes |
Zepbound and Mounjaro are the same medicine, tirzepatide. Mounjaro is the version approved for type 2 diabetes. Our Zepbound vs Mounjaro comparison explains why the name on the box changes what you pay, and our Trulicity vs Mounjaro comparison covers the diabetes matchup.
Can you take Trulicity and Zepbound together?
No, not as a rule. Zepbound's label says using it with any other GLP-1 medicine isn't recommended, and Trulicity is a GLP-1 medicine. If you're on Trulicity and want to talk about Zepbound, that's a switch your prescriber plans, not an add-on.
Don't stop, start or change doses on your own. The two drugs aren't dosed milligram for milligram, and your prescriber decides where you'd start.
Which works better for weight loss?
Zepbound, by a wide margin in its own trials. But no trial has tested Zepbound against Trulicity for weight loss, so these numbers come from separate studies:
| Trial (from each FDA label) | Who was in it | Dose | Weight change |
|---|---|---|---|
| Zepbound Study 1 (72 weeks) | Adults with obesity or overweight, no diabetes | 5 mg / 10 mg / 15 mg weekly | 15.0% / 19.5% / 20.9% lost (placebo 3.1%) |
| Zepbound Study 2 (72 weeks) | Adults with obesity or overweight and type 2 diabetes | 10 mg / 15 mg weekly | 12.8% / 14.7% lost (placebo 3.2%) |
| Trulicity AWARD-11 (36 weeks) | Adults with type 2 diabetes on metformin | 1.5 mg / 3 mg / 4.5 mg weekly | 3.0 kg / 3.8 kg / 4.6 kg lost (about 7 / 8 / 10 lb) |
What this means for you:
- Trulicity's weight loss is a side benefit, not its job. In AWARD-11, the top 4.5 mg dose took off about 4.6 kg on average from a starting weight of about 95 kg, close to 5% (our math). Trulicity has no weight-loss approval.
- Diabetes makes weight harder to lose on either drug. Zepbound's results were lower in people with type 2 diabetes (12.8% to 14.7%) than without it (15.0% to 20.9%).
- The trials differ in length and population, so treat this as a direction, not an exact race.
Is Zepbound better than Trulicity for the heart?
Tirzepatide, the drug in Zepbound and Mounjaro, has been tested head to head against Trulicity for heart outcomes. In the SURPASS-CVOT trial, 13,299 adults with type 2 diabetes and heart or blood vessel disease took weekly tirzepatide (up to 15 mg) or Trulicity 1.5 mg.
- A heart attack, stroke or heart-related death happened in 12.2% on tirzepatide vs 13.1% on Trulicity.
- That met the bar for "no worse than" Trulicity, but not for "better than."
- Stomach side effects were more common with tirzepatide.
The trial was funded by Eli Lilly, which makes both drugs. Trulicity is the one with an FDA-approved heart-risk claim on its label. Zepbound's label doesn't include one.
Trulicity vs Zepbound side effects
They share the same main side effects: nausea, diarrhea, vomiting and stomach pain. Each label lists them from its own placebo-controlled trials, so these aren't head-to-head numbers:
| Nausea in each drug's own trials (not head to head) | Placebo | Drug |
|---|---|---|
| Trulicity 0.75 mg weekly (type 2 diabetes trials) | 5.3% | 12.4% |
| Trulicity 1.5 mg weekly (type 2 diabetes trials) | 5.3% | 21.1% |
| Zepbound 5 mg weekly (weight-loss trials) | 8% | 25% |
| Zepbound 15 mg weekly (weight-loss trials) | 8% | 28% |
Both labels carry the same boxed warning, the FDA's most serious kind: in rodents, both drugs caused thyroid C-cell tumors, and it isn't known if that happens in people. Do not use either if you or a family member has had medullary thyroid cancer (MTC), or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Both labels also warn about pancreatitis, gallbladder problems, kidney injury from dehydration, and low blood sugar when used with insulin or sulfonylureas.
Get medical help right away for severe belly pain that won't go away, signs of an allergic reaction, or a lump or swelling in your neck. Our GLP-1 side effects comparison chart lines up more drugs.
Trulicity vs Zepbound cost: which is cheaper?
Paying cash, Zepbound's 2.5 mg starting dose costs less than Trulicity, and every other Zepbound dose costs more. With insurance, it depends almost entirely on why you're taking it.
List price is what Lilly charges wholesalers before discounts. Lilly says the price you pay depends mostly on your insurance.
| Trulicity | Zepbound | |
|---|---|---|
| List price | $1,006.93 a month | $499 to $1,086.37 per fill |
| LillyDirect self-pay | Starting at $389 a month, any dose (0.75 to 4.5 mg) | $299 (2.5 mg), $399 (5 mg), $449 (7.5 to 15 mg) if you refill within 45 days; otherwise $499 (7.5 mg) or $699 (10 to 15 mg) |
| How it comes | Single-dose pen | Single-dose pen; through self-pay, a single-dose vial or a KwikPen (you buy needles or syringes separately) |
| Commercial insurance | Lilly says about 40% of patients with employer or private insurance pay $0 and 90% pay under $75 | As little as $25 for a 1- or 3-month supply with Lilly's savings card, if your plan covers it |
| Medicare | Lilly says about 70% of patients pay $0 and 90% pay under $47 | Depends on your plan and why it's prescribed; see our Medicare and Zepbound guide |
Zepbound's 2.5 mg dose is a starting dose only, not a dose you stay on. Plans cover Trulicity for type 2 diabetes. Zepbound coverage for weight loss varies a lot by plan, so check yours before you fill.
For more, see Trulicity price, the cheapest ways to get Zepbound without insurance, the Zepbound savings card and does insurance cover Zepbound for weight loss.
Compare GLP-1 costs for your situation
Should you switch from Trulicity to Zepbound?
Only if your prescriber agrees it fits. Here's how the choice tends to break down:
| If this sounds like you | The option to ask your prescriber about first |
|---|---|
| You have type 2 diabetes and Trulicity controls it well | Staying on Trulicity, which is approved and usually covered for diabetes |
| You have type 2 diabetes and need more blood sugar or weight help | Mounjaro, the diabetes version of tirzepatide. Our Trulicity vs Mounjaro and Trulicity vs Ozempic pages compare the usual next steps |
| You don't have diabetes and want weight loss | Zepbound or another weight-loss GLP-1, since Trulicity isn't approved for weight loss. See Zepbound vs Wegovy |
| You have obesity and sleep apnea | Zepbound is the only one of the two approved for sleep apnea |
| Your child, 10 or older, takes Trulicity for diabetes | Ask the prescriber. Zepbound isn't approved for children |
| You're paying cash | Compare Lilly's self-pay prices by dose, above |
Our GLP-1 comparison covers the rest of the field, including daily pills.
Find the GLP-1 option that fits you
What we actually verified
- Read the Trulicity prescribing information (revised March 2026) and the Zepbound prescribing information (revised August 2026) for uses, doses, warnings, side-effect rates and trial results.
- Read the SURPASS-CVOT trial abstract on PubMed.
- Opened Lilly's Trulicity and Zepbound pricing pages and the LillyDirect Trulicity and Zepbound pages.
- Did the kilogram-to-pound and percent math ourselves.
All checks were done on November 2, 2026. What we did not do: get a quote from any insurer or pharmacy, check discount-card prices, or check pharmacy stock. Prices change, so confirm before you fill.
Frequently asked questions
Is Trulicity the same as Zepbound?
No. Trulicity is dulaglutide, a weekly shot for type 2 diabetes that works on one hormone, GLP-1. Zepbound is tirzepatide, a weekly shot for weight loss and sleep apnea that works on two, GIP and GLP-1. Both are made by Eli Lilly.
Which is better for weight loss, Trulicity or Zepbound?
Zepbound. In its label trials, adults without diabetes lost 15.0% to 20.9% of their weight over 72 weeks. Trulicity isn't approved for weight loss; in its AWARD-11 trial, adults with type 2 diabetes lost 3.0 to 4.6 kg over 36 weeks. No trial has compared them directly for weight.
Can I take Trulicity and Zepbound at the same time?
Zepbound's label says using it with any other GLP-1 medicine isn't recommended, and Trulicity is a GLP-1 medicine. Talk to your prescriber about switching instead.
Is Zepbound cheaper than Trulicity?
Only at the 2.5 mg starting dose. LillyDirect lists Zepbound at $299 (2.5 mg) and $399 (5 mg) a month vs Trulicity starting at $389 for any dose. Higher Zepbound doses are $449 a month if you refill within 45 days, or $499 to $699 otherwise. With insurance, Trulicity is usually covered for diabetes, while Zepbound coverage for weight loss varies.
Can Zepbound be used for type 2 diabetes?
Zepbound isn't FDA-approved for type 2 diabetes. The same medicine, tirzepatide, is approved for type 2 diabetes as Mounjaro.
Still not sure which GLP-1 path fits you? Take The RX Index's free Find My GLP-1 Path quiz — about 2 minutes, no signup.
Sources
- Trulicity prescribing information (Eli Lilly, revised March 2026; checked November 2, 2026)
- Zepbound prescribing information (Eli Lilly, revised August 2026; checked November 2, 2026)
- SURPASS-CVOT: tirzepatide vs dulaglutide cardiovascular outcomes, NEJM, 2025 (PubMed) (checked November 2, 2026)
- Lilly: Trulicity cost information (list price) and Zepbound cost information (list price) (checked November 2, 2026)
- LillyDirect: Trulicity self-pay and Zepbound self-pay (checked November 2, 2026)